Thalassemia (skull manifestation)
Known case of thalassaemia major. CT for work up of developmental delay.
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Diffuse widening of the diploic space of the calvarial bones (except the occipital bone) with typical hair on end appearance, more prominent in the frontal bones.
Thickening of facial bones is also noted.
No pneumatization of the frontal, maxillary, and sphenoid sinuses. Normal pneumatization of the ethmoid air cells.
No gross abnormality in the brain parenchyma.
The skull manifestations of thalassemia include:
- widening of the diploic space
- thinning of the inner & outer table
- prominent secondary trabeculae (hair on end appearance)
- the occipital bone is spared (lack of haemopoietic bone marrow)
- hypopneumatisation of the frontal, maxillary & sphenoid sinuses (filled with marrow containing bone)
- ethmoid sinuses are spared as they contain no red bone marrow
- dental malocclusion
- Adam, Andy, et al. Grainger & Allison's Diagnostic Radiology E-Book. Elsevier Health Sciences, 2014.